Member Forum

1.  in house pharmacy billing

Posted 11-10-2017 04:21
Does anyone here do an in house pharmacy and bill insurance and get paid?

I'm thinking about adding some meds for hand out in my office, but I don't know what CPTs to bill payers, and I don't know if there are any legal things to be aware of (eg labelling, record keeping).   I know there are companies that set up this stuff for you, but I would rather try to learn the ropes myself.

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PJ
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2.  RE: in house pharmacy billing

Posted 11-11-2017 00:19
I have had clinics where we have dispensed medication to patients. This was on a cash basis for the reason given below.
The software to bill insurance companies for medication like what the pharmacies use costs several thousand dollars. Insurance companies will not pay without this.  The use NDC codes rather than CPT.

Also office dispensing laws vary by state. In my state the labeling requirements are the same as if the patient had received medication from a pharmacy storage requirements and logs required are the same.

This not a revenue center for your office unless you have quite a volume.  More of a pain than it is worth.
I only did it in clinics where the nearest pharmacy was  70 miles away.

Also because of my pharmacy license, I had more dispensing latitude than most physicians.

Bruce Carlson, RPh, MD

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Bruce Carlson
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3.  RE: in house pharmacy billing

Posted 11-11-2017 05:50
I have a dispensary in my office, but do not bill insurance. Fewer hassles this way. Patients appreciate the convenience and I keep the cost reasonable.

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Tracy Baum
Mountain Sage Family Clinic
Dubois, WY
307-455-2807
baumnp@gmail.com
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